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Ragsdale HB, Butler MS, Koning SM, Bas IN, McDade TW. Lower Socioeconomic Status Predicts Increased Proinflammatory Signaling in Late Pregnancy: Evidence From a Filipino Cohort. Am J Hum Biol 2024:e24161. [PMID: 39376133 DOI: 10.1002/ajhb.24161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/21/2024] [Accepted: 09/17/2024] [Indexed: 10/09/2024] Open
Abstract
OBJECTIVES Maternal socioeconomic status (SES) is an important predictor of adverse birth outcomes and postnatal health across global populations. Chronic inflammation is implicated in cardiometabolic disease risk in high-income contexts and is a potential pathway linking maternal adversity to offspring health trajectories. To clarify how socioeconomic inequality shapes pregnancy inflammation in middle-income settings, we investigated SES as a predictor of inflammatory cytokines in late gestation in a sample from the Cebu Longitudinal Health Nutrition Survey in Cebu, Philippines. METHODS We used multiple regression to evaluate maternal SES, reflected in household assets, as a predictor of general inflammation (C-reactive protein), inflammatory cytokines (interleukin-6, interleukin-10), and inflammatory balance (n = 407). Inflammatory markers were measured at 29.9 weeks gestation in dried blood spots, and a measure reflecting relative balance of IL6 and IL10 was calculated to capture pro- versus anti-inflammatory skewed immune profiles. RESULTS Greater household assets significantly predicted lower IL6 concentration (p < 0.001), with a trend toward lower IL6 relative to IL10 (p = 0.084). C-reactive protein and IL10 were not individually related to SES. CONCLUSIONS The inverse relationship between SES and pregnancy inflammation in Cebu is consistent with results from high-income settings. These findings further highlight the influence of socioeconomic conditions on immune regulation during pregnancy. Given the evidence that gestational inflammation impacts offspring fetal growth, our results suggest that social and economic effects on immune function may be an important pathway for the intergenerational transmission of health disparities.
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Affiliation(s)
- Haley B Ragsdale
- Department of Anthropology, University of Illinois Chicago, Chicago, Illinois, USA
| | - Margaret S Butler
- Center of Excellence in Maternal and Child Health, Division of Community Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA
| | | | - Isabelita N Bas
- Office of Population Studies Foundation Inc., University of San Carlos, Cebu, Philippines
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
- Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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Müller B, Gaul C, Reis O, Jürgens TP, Kropp P, Ruscheweyh R, Straube A, Brähler E, Förderreuther S, Rimmele F, Dresler T. Household income is associated with attack frequency, but not with the prevalence of headache: an analysis of self-reported headache in the general population in Germany. J Headache Pain 2024; 25:164. [PMID: 39354353 PMCID: PMC11443947 DOI: 10.1186/s10194-024-01844-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/13/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Headache disorders are among the most prevalent neurological disorders worldwide. However, whether groups differing in socioeconomic position (SEP) are disproportionately affected by headache disorders has not yet been adequately clarified. Our aim was to analyse (1) the headache prevalence by socioeconomic position (SEP) and (2) the attack frequency by SEP in a German population-based adult sample. METHODS Cross-sectional data from a random general population were used. The sample included N = 2,189 participants aged ≥ 18 years. SEP was measured using net equivalised income (NEI) and education. A binary logistic regression model tested the effect of SEP in predicting the prevalence of headache in general. Ordinal logistic regressions were modeled to predict the effect of SEP on the likelihood of attack frequency. Attack frequency was categorized in low frequency episodic headache (LFEH: 0-3 days per month), moderate frequency episodic headache (MFEH: 4-14 days per month) and chronic headache (CH: ≥ 15 days per month). RESULTS Of the 2,189 participants, 891 reported headache in the last six months. Neither income nor education was associated with headache prevalence. However, significant differences between income groups were found for attack frequency. Compared to participants with NEI > 150%, those with NEI < 60% were 5.21 times more likely (95%CI 2.03, 13.36) to experience higher headache frequency, and those with NEI between 60 and 150% were 2.29 times more likely (95%CI 1.02, 5.11), with adjustments made for a set of potential confounders, including depressive symptoms. CONCLUSIONS To reduce headache attacks, it is essential to address both low- and middle-income groups affected by headaches. Universal public health prevention campaigns are particularly appropriate.
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Affiliation(s)
- Britta Müller
- Institute of Medical Psychology and Medical Sociology, Rostock University Medical Center, Gehlsheimer Str. 20, Rostock, 18147, Germany.
| | - Charly Gaul
- Headache Center Frankfurt, Frankfurt, Germany
| | - Olaf Reis
- Department of Child and Adolescent Psychiatry and Neurology, University Medical Center Rostock, Rostock, Germany
- German Center for Child and Adolescent Health (DZKJ), partner site Greifswald/ Rostock, Rostock, Germany
| | - Tim P Jürgens
- Department of Neurology, University Medical Center Rostock, Rostock, Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, Rostock University Medical Center, Gehlsheimer Str. 20, Rostock, 18147, Germany
| | - Ruth Ruscheweyh
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Andreas Straube
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center (IFB) Adiposity Diseases - Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | | | - Florian Rimmele
- Department of Neurology, Headache Center North-East, University Medical Center Rostock, Rostock, Germany
| | - Thomas Dresler
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital Tübingen, Tübingen, Germany
- LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
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Mayorga NA, Smit T, Salwa A, Buitron V, Garza M, Ochoa-Perez M, Lemaire C, Zvolensky MJ. Examining Financial Strain and Subjective Social Status in Terms of Behavioral Health Among Latinx Adults in a Federally Qualified Health Center. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02146-2. [PMID: 39287763 DOI: 10.1007/s40615-024-02146-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/19/2024]
Abstract
There is a growing recognition that Social Determinants of Health (SDoH) can inform some sources of physical and mental health disparities among the Latinx population. The current study sought to expand previous research by exploring the singular and interactive influence of financial strain and subjective social status-two common and clinically important SDoH factors-on pain intensity, pain disability, general depression, social anxiety, and anxious arousal. The current sample consisted of 155 Latinx adults (81.3% female; Mage = 40.02 years, SD = 10.61) presenting for care at a Federally Qualified Health Center (FQHC). Multivariate results demonstrated that financial strain was statistically significantly associated with greater pain intensity, pain disability, general depression, and anxious arousal, but not social anxiety. Further, lower subjective social status was related to greater general depression, social anxiety, and anxious arousal but not with higher levels of pain indices. An interactive effect was found wherein the combination of higher levels of financial strain and low levels of subjective social status was related to general depression and anxious arousal. This is the first study to empirically evaluate the main and interactive effects of financial strain and subjective social status regarding numerous physical and mental health symptoms. These findings clarify how two prevalent SDoH factors influence health outcomes. Specifically, the results suggest that a multi-risk conceptualization can advance a fine-grained understanding of Latinx health disparities by showing differential associations between SDoH factors and clinical outcomes that are frequently the source of health inequities in the Latinx population.
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Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Aniqua Salwa
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Victor Buitron
- Department of Psychology, Florida International University, Miami, FL, USA
| | | | | | | | - Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Santoniccolo F, Rollè L. The role of minority stress in disordered eating: a systematic review of the literature. Eat Weight Disord 2024; 29:41. [PMID: 38850334 PMCID: PMC11162380 DOI: 10.1007/s40519-024-01671-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/30/2024] [Indexed: 06/10/2024] Open
Abstract
PURPOSE Sexual and gender minorities (SGMs) show a heightened risk of disordered eating compared to heterosexual and cisgender people, a disparity which may be caused by exposure to minority-specific stressors, such as discrimination and violence. This systematic review aims to summarize available evidence on the role of minority stress in disordered eating and SGM-specific aspects. METHODS Following PRISMA guidelines, scientific search engines (EBSCO, PUBMED, Web of Science) were screened up to 31st of January 2024, including English-language original research papers containing analyses of the relationship between minority stress and disordered eating. 2416 records were gathered for screening. After application of inclusion and exclusion criteria, thematic analysis was conducted regarding 4 research questions: effects of minority stress on disordered eating, mediating factors, specificities of SGMs and differences between identity categories. RESULTS 30 studies were included. Several aspects of minority stress are reliably associated with different forms of disordered eating. The relationship between minority stressors and disordered eating is mediated by aspects such as shame, body shame, or negative affect. SGMs show several specificities, such as the presence of a role of LGBTQIA + communities and additional gender-related pressures. Bisexual people and gender minorities appear to feature comparatively higher risks, and gender-related factors shape paths leading to disordered eating risk. CONCLUSION Minority stress is an important predictor of disordered eating, making SGM people's health particularly at risk. Institutional and organizational anti-discrimination policies are needed, as well as further research. Clinical interventions may benefit from exploring and incorporating how minority stressors impact SGM people. Evidence level I-Systematic review.
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Affiliation(s)
- Fabrizio Santoniccolo
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Torino, TO, Italy.
| | - Luca Rollè
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Torino, TO, Italy
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Korous KM, Brooks E, King-Mullins EM, Lucas T, Tuuhetaufa F, Rogers CR. Perceived Economic Strain, Subjective Social Status, and Colorectal Cancer Screening Utilization in U.S. Men-A Cross-Sectional Analysis. Behav Med 2024:1-10. [PMID: 38618978 DOI: 10.1080/08964289.2024.2335156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/19/2024] [Indexed: 04/16/2024]
Abstract
Although socioeconomic status (SES) is fundamentally related to underutilization of colorectal cancer (CRC) screening, the role of perceived economic strain and subjective social status with CRC screening is understudied. The aim of this study was to investigate whether greater perceived economic strain or lower subjective social status would decrease the odds of CRC screening uptake and being up-to-date with guideline-recommended CRC screening. We also explored interactions with household income and educational attainment. Cross-sectional survey-based data from men aged 45-75 years living in the United States (N = 499) were collected in February 2022. Study outcomes were ever completing a stool- or exam-based CRC screening test and being up-to-date with CRC screening. Perceived economic strain and subjective social status were the predictors. We conducted logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI). Greater perceptions of economic strain decreased odds of being up-to-date with CRC screening. Household income modified the association between perceived economic strain and completing a stool-based test; the association was stronger for men from lower-income households. In unadjusted models, higher subjective social status increased odds of completing an exam-based test and being up-to-date with CRC screening. Our findings suggest that experiencing economic strain may interfere with men's CRC screening decisions and may capture additional information about barriers to CRC screening utilization beyond those captured by income or education.
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Affiliation(s)
- Kevin M Korous
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ellen Brooks
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Todd Lucas
- College of Human Medicine, Division of Public Health, Michigan State University, Flint, MI, USA
| | - Fa Tuuhetaufa
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Charles R Rogers
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
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Hoke MK, Long AM. Human biology and the study of precarity: How the intersection of uncertainty and inequality is taking us to new extremes. Am J Hum Biol 2024; 36:e24018. [PMID: 38053455 DOI: 10.1002/ajhb.24018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 12/07/2023] Open
Abstract
Inequality represents an extreme environment to which humans must respond. One phenomenon that contributes to this growing extreme is precarity or the intersection of uncertainty and some form of inequality. While precarity has an important intellectual history in the fields of sociology and sociocultural anthropology, it has not been well studied in the field of human biology. Rather human biologists have engaged with the study of closely related concepts such as uncertainty and resource insecurity. In this article, we propose that human biology take on the study of precarity as a novel way of investigating inequality. We first provide a brief intellectual history of precarity which is followed by a review of research on uncertainty and resource security in human biology which, while not exhaustive, illustrates some key gaps that precarity may aid us in addressing. We then review some of the pathways through which precarity comes to affect human biology and health and some of the evidence for why the unpredictable nature of precarity may make it a unique physiological stress. A case study based on research in Nuñoa, Peru provides an important example of how precarity can elucidate the influences of health in an extreme setting, albeit with insights that apply more broadly. We conclude that precarity holds important potential for the study of human biology, including helping us more effectively operationalize and study uncertainty, encouraging us to explore the predictability of resources and stressors, and reminding us to think about the intersectional nature of stressors.
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Affiliation(s)
- Morgan K Hoke
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anneliese M Long
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Paoletti J, Phetmisy CN, Lai VD, Fagundes CP. Perceived income inadequacy is associated with Epstein-Barr Virus latency and mental health outcomes in informal caregivers who are also employed in the healthcare industry. Psychoneuroendocrinology 2023; 158:106388. [PMID: 37729703 DOI: 10.1016/j.psyneuen.2023.106388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/24/2023] [Accepted: 09/10/2023] [Indexed: 09/22/2023]
Abstract
Finances are a prevalent source of stress. In a sample of 799 nursing home workers measured multiple times over 18 months, we found that higher perceived income inadequacy, the perception that one's expenses exceeds one's incomes, was associated with poorer self-reported mental health indicators and Epstein-Barr Virus antibody titers (a marker of cell-mediated immune function). Perceived income inadequacy predicted outcomes over and above the role of other socioeconomic status variables (objective household income and education). Mental health variables were not related to Epstein-Barr Virus antibody titers. Additionally, we found an interaction between perceived income inadequacy and informal caregiver status on our mental health outcomes; informal caregivers with higher perceived income inadequacy had poorer mental health than non-caregivers with the same perceived income inadequacy. Our findings may add nuance to the reserve capacity model, which states that those at lower socioeconomic levels are at higher risk of adverse health outcomes partly because they have fewer resources to address demands and strain. Perceived income inadequacy may significantly predict mental and physical well-being beyond other socioeconomic status variables, especially among lower-income employees. Caregiving stress and perceived income inadequacy may have synergistic effects on mental health.
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Affiliation(s)
| | | | | | - Christopher P Fagundes
- Rice University, USA; University of Texas MD Anderson Cancer Center, USA; Baylor College of Medicine, USA
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Lai S, Lu L, Shen C, Yan A, Lei Y, Zhou Z, Wang Y. Income loss and subsequent poor psychological well-being among the Chinese population during the early COVID-19 pandemic. Int J Equity Health 2023; 22:219. [PMID: 37848883 PMCID: PMC10583462 DOI: 10.1186/s12939-023-02022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had major ramifications for health and the economy at both the individual and collective levels. This study examined exogenous negative changes in household income and their implications on psychological well-being (PWB) among the Chinese population during the COVID-19 pandemic. METHODS Data were drawn from the early China COVID-19 Survey, a cross-sectional anonymous online survey administered to the general population in China. Self-reported PWB was measured using a 5-point Likert scale with five questions related to the participants' recent psychological state. Hierarchical multiple linear regression was employed to examine whether income loss during the COVID-19 pandemic was associated with poor psychological health. RESULTS This study included 8,428 adults, of which 90% had suffered from a moderate or severe loss of household income due to the early COVID-19 pandemic. Those who had experienced moderate or severe loss of income scored significantly lower on psychological well-being than those who did not experience income loss (19.96 or 18.07 vs. 21.46; P < 0.001); after controlling for confounders, income loss was negatively associated with PWB scores (moderate income loss: B = - 0.603, P < 0.001; severe income loss: B = - 1.261, P < 0.001). An interaction effect existed between the degree of income loss and pre-pandemic income groups. Specifically, participants in the middle-income group who had suffered severe income loss scored the lowest on PWB (B = - 1.529, P < 0.001). There was also a main effect on income loss, such that participants with varying degrees of income loss differed across five dimensions, including anhedonia, sleep problems, irritability or anger, difficulty with concentration, and repeated disturbing dreams related to COVID-19. CONCLUSIONS Income loss during the pandemic has had detrimental consequences on psychological well-being, and the magnitude of the impact of income loss on psychological well-being varied according to previous income levels. Future policy efforts should be directed toward improving the psychological well-being of the economically vulnerable and helping them recover from lost income in the shortest time possible.
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Affiliation(s)
- Sha Lai
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Li Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Chi Shen
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Alice Yan
- Division of Research Patient Care Services, Stanford Health Care, Palo Alto, CA, 94305, USA
| | - Yanjun Lei
- Department of Pathogenic Microbiology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
| | - Youfa Wang
- School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, China.
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Surachman A, Tucker-Seeley R, Almeida DM. The association between material-psychological-behavioral framework of financial hardship and markers of inflammation: a cross-sectional study of the Midlife in the United States (MIDUS) Refresher cohort. BMC Public Health 2023; 23:1845. [PMID: 37735377 PMCID: PMC10514981 DOI: 10.1186/s12889-023-16745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Measures of financial hardship have been suggested to supplement traditional indicators of socioeconomic status (SES) to elucidate household economic well-being. This study formally tested the construct validity of financial hardship and examined its association with markers of inflammation. METHODS This study utilized data from the Midlife Development in the United States Refresher Study (MIDUS-R; Age = 23-76, 53.7% female, 71% white). Participants were divided into exploratory factor analysis (EFA; completed SAQs only; N = 2,243) and confirmatory factor analysis sample (CFA; completed SAQs and biomarker assessment; N = 863). Analysis was divided into three steps. First, exploratory factor analysis (EFA) is used to examine if the three-domain factor (material, psychological, and behavioral) is the best fitting model for financial hardship measures. Second, we conducted CFA to test the hypothesized three-factor measurement model of financial hardship. Third, we tested the association between domains and the general latent factor of financial hardship and inflammation (interleukin 6/IL6, c-reactive protein/CRP, and fibrinogen). RESULTS Results from EFA supported the three-domain model of financial hardship. The hypothesized three-domain measurement model fits well in a different sample within MIDUS-R. In the models adjusted for age and sex, higher material hardship was associated with elevated IL6, CRP, and fibrinogen, while higher behavioral hardship was associated with higher CRP. The association between the material domain and IL6 remained significant after adding body mass index, education, and race as additional covariates. The second-order financial hardship measurement model was associated with IL6, CRP, and fibrinogen, adjusted for age, sex, BMI, education, and race. CONCLUSION Explicating the socioeconomic environment to include indicators of financial hardship can help researchers better understand the pathway between SES and the inflammation process, which may help elucidate pathways between SES and age-related chronic diseases associated with inflammation.
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Affiliation(s)
- Agus Surachman
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, 19104, USA.
- College of Nursing and Health Professions, Drexel University, Philadelphia, 19104, USA.
| | | | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, 16802, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802, USA
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Brewer K, Waring JJC, Noble B, Bradley D, Olurotimi O, Fronheiser J, Sifat MS, Ehlke SJ, K Boozary L, McQuoid J, Kendzor DE, Alexander AC. Pandemic-Related Stress May Be Associated with Symptoms of Poor Mental Health Among African Americans. J Racial Ethn Health Disparities 2023; 10:2028-2038. [PMID: 35953609 PMCID: PMC9371371 DOI: 10.1007/s40615-022-01383-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 12/02/2022]
Abstract
The COVID-19 pandemic has disproportionately affected African Americans and has been a significant source of stress for this population due to increased economic hardship and social isolation. This study characterized the associations between COVID-19 vulnerability (e.g., contracting the illness or losing a loved one), pandemic-related stress, and symptoms of poor mental health among African Americans. The study sample included African Americans (N = 304) who responded to an online survey. Symptoms of poor mental health were assessed using the PHQ-4, which assessed symptoms of depression and anxiety. Vulnerability to COVID-19 was measured via self-report in three ways: (1) personal vulnerability, (2) family vulnerability, and (3) community vulnerability (i.e., friends, neighbors, and co-workers). Pandemic-related stress was measured by asking participants to rate how difficult it has been to access essential resources and services, manage finances, and plan or attend social events since March 13, 2020. Data were analyzed using multivariable logistic regression. Results showed that COVID-19 vulnerability was not associated with symptoms of depression or anxiety, but pandemic-related stress was consistently associated with symptoms of poor mental health. Study findings highlight the need to monitor and intervene on pandemic-related stress to prevent further psychological distress within this vulnerable and underserved population.
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Affiliation(s)
- Khandis Brewer
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Joseph J C Waring
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Bishop Noble
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - David Bradley
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Oluwakemi Olurotimi
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jack Fronheiser
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Munjireen S Sifat
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sarah J Ehlke
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Laili K Boozary
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Psychology, The University of Oklahoma, Norman, OK, USA
| | - Julia McQuoid
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adam C Alexander
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Burke NL, Hazzard VM, Schaefer LM, Simone M, O’Flynn JL, Rodgers RF. Socioeconomic status and eating disorder prevalence: at the intersections of gender identity, sexual orientation, and race/ethnicity. Psychol Med 2023; 53:4255-4265. [PMID: 35574702 PMCID: PMC9666565 DOI: 10.1017/s0033291722001015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Longstanding biases have fostered the erroneous notion that only those of higher socioeconomic status (SES) experience eating disorders (EDs); however, EDs present across all SES strata. Considering the dearth of ED research among those of lower SES, this study examined (1) the overall association between SES and ED prevalence, and (2) ED prevalence in the context of four relevant social identities (i.e. SES, gender identity, sexual orientation, and race/ethnicity) from an intersectional perspective, as unique combinations of multiple social identities may differentially influence risk. METHODS A sample of 120 891 undergraduate/graduate students from the Healthy Minds Study self-reported family SES with a single-item question, gender identity, sexual orientation, and race/ethnicity, and were screened for ED risk. RESULTS Participants of lower SES had 1.27 (95% CI 1.25-1.30) times greater prevalence of a positive ED screen than those of higher SES. Substantial heterogeneity was observed across the four social identities beyond the association with SES. For example, positive ED screens were particularly common among lower SES, Latinx, sexual minority cisgender men and women, with 52% of bisexual men and 52% of lesbian women of Latinx ethnicity and lower SES screening positive. CONCLUSIONS Although positive ED screens were more common among undergraduate/graduate students of lower SES, the particularly high ED risk reported by certain groups of lower SES with multiple minority identities reinforces the importance of investigating multi-layered constructs of identity when identifying groups at disproportionate risk.
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Affiliation(s)
- Natasha L. Burke
- Department of Psychology, Fordham University, 441 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA
| | - Vivienne M. Hazzard
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA, 55454
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA, 55454
| | - Lauren M. Schaefer
- Sanford Center for Bio-behavioral Research, 120 Eighth Street South, Fargo, ND 58103, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm Street N, Fargo, ND, 58102, USA
| | - Melissa Simone
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA, 55454
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA, 55454
| | - Jennifer L. O’Flynn
- Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, MA, 02139, USA
| | - Rachel F. Rodgers
- Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
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12
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Gladstone J, Barrett JAM. Understanding the functional form of the relationship between childhood cognitive ability and adult financial well-being. PLoS One 2023; 18:e0285199. [PMID: 37285329 PMCID: PMC10246798 DOI: 10.1371/journal.pone.0285199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/18/2023] [Indexed: 06/09/2023] Open
Abstract
The increasing complexity of the modern financial landscape presents significant challenges for individuals' financial well-being. In this study, we aim to investigate the relationship between cognitive ability and financial well-being by utilizing data from the British Cohort Study, which follows a sample of 13,000 individuals from birth in 1970 to the present day. Our objective is to examine the functional form of this relationship while controlling for factors such as childhood socio-economic status and adult income. Previous research has established a correlation between cognitive ability and financial well-being, but has implicitly assumed a linear relationship. Our analyses indicate that the majority of the relationships between cognitive ability and financial variables are monotonic. However, we also observe non-monotonic relationships, particularly for credit usage, suggesting a curvilinear relationship where both lower and higher levels of cognitive ability are associated with lower levels of debt. These findings have important implications for understanding the role of cognitive ability in financial well-being and for financial education and policy, as the complexity of the modern financial landscape poses significant challenges for individuals' financial well-being. As financial complexity is increasing and cognitive ability is a key predictor of knowledge acquisition, misspecifying the true relationship between cognitive ability and financial outcomes leads to an undervaluation of the role of cognitive ability for financial well-being.
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Affiliation(s)
- Joe Gladstone
- Leeds School of Business, University of Colorado, Boulder, Colorado, United States of America
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13
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Rogers ML, Cao E, Richards JA, Mitelman A, Barzilay S, Blum Y, Chistopolskaya K, Çinka E, Dudeck M, Husain MI, Kantas Yilmaz F, Kuśmirek O, Luiz JM, Menon V, Nikolaev EL, Pilecka B, Titze L, Valvassori SS, You S, Galynker I. Changes in Daily Behaviors and Cognitions During the COVID-19 Pandemic: Associations With Suicide Crisis Syndrome and Suicidal Ideation. Clin Psychol Sci 2023; 12:21677026221148732. [PMCID: PMC10164456 DOI: 10.1177/21677026221148732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/12/2022] [Indexed: 10/05/2024]
Abstract
The COVID-19 pandemic resulted in drastic disruptions to lives and possible pernicious impacts on mental health, including suicidality. Understanding these relations, as well as impacts on at-risk populations, is essential. The present study examined changes in daily behaviors and cognitions after the implementation of physical/social distancing mandates in individuals with symptoms of suicide crisis syndrome (SCS) and/or suicidal ideation. Adults (N = 5,528) across 10 countries completed online self-report measures. There were significant main effects of time and various configurations of interactions between time, SCS, and suicidal ideation in predicting behaviors (outdoor and social engagements) and cognitions (thoughts about health, finances, and living situation). Cross-culturally, individuals with more severe SCS symptoms generally had the largest changes in behaviors and cognitions, though this effect was not replicated across all countries. Overall, these findings highlight the implications of the potentially mutually exacerbating influences of routine disruptions and suicide risk and the importance of examining associations cross-culturally.
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Affiliation(s)
| | - Erjia Cao
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel
| | | | - Alexis Mitelman
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel
| | - Shira Barzilay
- Department of Community Mental Health, University of Haifa
| | - Yarden Blum
- Department of Psychology, College of Management
| | | | - Elif Çinka
- Department of Health Management, University of Health Sciences
| | - Manuela Dudeck
- Department of Forensic Psychiatry and Psychotherapy, Ulm University
| | - M. Ishrat Husain
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto
| | | | | | - Jhoanne M. Luiz
- Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC)
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research
| | - Evgeni L. Nikolaev
- Social and Clinical Psychology Department, Ulianov Chuvash State University
| | | | - Larissa Titze
- Department of Forensic Psychiatry and Psychotherapy, Ulm University
| | - Samira S. Valvassori
- Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC)
| | - Sungeun You
- Department of Psychology, Chungbuk National University
| | - Igor Galynker
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel
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14
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Olender M, Riegel L. Aging Has Economic Costs to North Carolina Workers, Taxpayers, and Small Business Owners. N C Med J 2023; 84:96-99. [PMID: 39302323 DOI: 10.18043/001c.73000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
Retirement security is deeply connected with health security for older adults, and public policy needs to incorporate these interrelationships more fully.
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15
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Brucki BM, Bagade T, Majeed T. A health impact assessment of gender inequities associated with psychological distress during COVID19 in Australia's most locked down state-Victoria. BMC Public Health 2023; 23:233. [PMID: 36732738 PMCID: PMC9894749 DOI: 10.1186/s12889-022-14356-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/29/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Since March 2020, when the COVID19 pandemic hit Australia, Victoria has been in lockdown six times for 264 days, making it the world's longest cumulative locked-down city. This Health Impact Assessment evaluated gender disparities, especially women's mental health, represented by increased levels of psychological distress during the lockdowns. METHODS A desk-based, retrospective Health Impact Assessment was undertaken to explore the health impacts of the lockdown public health directive with an equity focus, on the Victorian population, through reviewing available qualitative and quantitative published studies and grey literature. RESULTS Findings from the assessment suggest the lockdown policies generated and perpetuated avoidable inequities harming mental health demonstrated through increased psychological distress, particularly for women, through psychosocial determinants. CONCLUSION Ongoing research is needed to elucidate these inequities further. Governments implementing policies to suppress and mitigate COVID19 need to consider how to reduce harmful consequences of these strategies to avoid further generating inequities towards vulnerable groups within the population and increasing inequalities in the broader society.
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Affiliation(s)
- Belinda M Brucki
- School of Medicine & Public Health, College of Health Medicine & Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
| | - Tanmay Bagade
- School of Medicine & Public Health, College of Health Medicine & Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Public Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tazeen Majeed
- School of Medicine & Public Health, College of Health Medicine & Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Public Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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16
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Philbrook LE, Simmons EJ. Sleepiness Moderates the Associations between Personality and Financial Risk Tolerance and Spending Habits among College Students. Behav Sleep Med 2022:1-13. [PMID: 36495083 DOI: 10.1080/15402002.2022.2154212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Personality and sleep characteristics are related to financial attitudes and behaviors. However, to our knowledge no study has examined how personality and sleep may be conjointly associated with these financial outcomes. The present study examined sleepiness as a moderator of the associations between college students' personality traits and financial risk tolerance and spending habits. METHODS Undergraduates (N = 177, 77% women, 78% White) self-reported their personality traits and sleepiness using well-established questionnaires. Financial attitudes and behaviors were assessed via students' self-reported responses to a set of scenarios assessing risk tolerance as well as their spending habits over the prior two weeks. RESULTS Multiple regression analyses were run. Across five significant two-way interactions, high levels of sleepiness exacerbated risk for greater financial risk tolerance and higher spending among those characterized by high open-mindedness and low neuroticism, whereas low sleepiness increased protection for lower risk tolerance and less spending among those high in agreeableness and conscientiousness. CONCLUSIONS Sleepiness may act as both a vulnerability and protective factor in relations between personality and financial attitudes and behaviors. Improvements in sleepiness, which is modifiable via intervention, may have significant implications for individuals' financial well-being.
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Affiliation(s)
- Lauren E Philbrook
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, NewYork, USA
| | - Eric J Simmons
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, NewYork, USA
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17
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Pala AN, Chuang JC, Chien A, Krauth DM, Leitner SA, Okoye NM, Costello SC, Rodriguez RM, Sheira LA, Solomon G, Weiser SD. Depression, anxiety, and burnout among hospital workers during the COVID-19 pandemic: A cross-sectional study. PLoS One 2022; 17:e0276861. [PMID: 36490248 PMCID: PMC9733879 DOI: 10.1371/journal.pone.0276861] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/16/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Healthcare personnel have faced unprecedented mental health challenges during the COVID-19 pandemic. The study objective is to assess differences in depression, anxiety, and burnout among healthcare personnel with various occupational roles and whether financial and job strain were associated with these mental health outcomes. METHODS We employed an anonymous survey between July and August 2020 at an urban county hospital in California, USA. We assessed depression, anxiety, and burnout using validated scales, and asked questions on financial strain and job strain. We performed logistic and linear regression analyses. RESULTS Nurses (aOR 1.93, 95% CIs 1.12, 3.46), social workers (aOR 2.61, 95% CIs 1.35, 5.17), service workers (aOR 2.55, 95% CIs 1.20, 5.48), and administrative workers (aOR 2.93, 95% CIs 1.57, 5.61) were more likely than physicians to screen positive for depression. The odds of screening positive for anxiety were significantly lower for ancillary workers (aOR 0.32, 95% CIs 0.13-0.72) compared with physicians. Ancillary (aB = -1.77, 95% CIs -1.88, -0.47) and laboratory and pharmacy workers (aB -0.70, 95% CI -1.34, -0.06) reported lower levels of burnout compared with physicians. Financial strain partially accounted for differences in mental health outcomes across job categories. Lack of time to complete tasks and lack of supervisory support were associated with higher odds of screening positive for depression. Less job autonomy was associated with higher odds of screening positive for anxiety and higher burnout levels. CONCLUSIONS We found significant disparities in mental health outcomes across occupational roles. Policies to mitigate the adverse impact of COVID-19 on health workers' mental health should include non-clinical staff and address financial support and job characteristics for all occupational roles.
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Affiliation(s)
- Andrea Norcini Pala
- Columbia School of Social Work (CSSW), New York, NY, United States of America
| | - Jessica C. Chuang
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Ai Chien
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - David M. Krauth
- San Francisco (UCSF) Division of HIV, University of California, Infectious Disease and Global Medicine, San Francisco, CA, United States of America
| | - Stefano A. Leitner
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Nnenna M. Okoye
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Sadie C. Costello
- Division of Environmental Health Sciences, University of California, Berkeley, School of Public Health, CA, United States of America
| | - Robert M. Rodriguez
- San Francisco (UCSF) Department of Emergency Medicine, University of California, San Francisco, CA, United States of America
| | - Lila A. Sheira
- San Francisco (UCSF) Division of HIV, University of California, Infectious Disease and Global Medicine, San Francisco, CA, United States of America
| | - Gina Solomon
- San Francisco (UCSF) Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, United States of America
| | - Sheri D. Weiser
- San Francisco (UCSF) Division of HIV, University of California, Infectious Disease and Global Medicine, San Francisco, CA, United States of America
- * E-mail:
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18
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Malik AO, Jones PG, Mena-Hurtado C, Burg MM, Shishehbor MH, Hejjaji V, Tran A, Spertus JA, Smolderen KG. Derivation and validation of a predictive model for chronic stress in patients with cardiovascular disease. PLoS One 2022; 17:e0275729. [PMID: 36256655 PMCID: PMC9578618 DOI: 10.1371/journal.pone.0275729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/22/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Chronic stress in patients with cardiovascular disease (CVD), including peripheral artery disease (PAD), is independently associated worse outcomes. A model that can reliably identify factors associated with risk of chronic stress in patients with CVD is needed. METHODS In a prospective myocardial infarction (MI) registry (TRIUMPH), we constructed a logistic regression model using 27 patient demographic, socioeconomic, and clinical factors, adjusting for site, to identify predictors of chronic stress over 1 year. Stress at baseline and at 1-, 6- and 12-month follow-up was measured using the 4-item Perceived Stress Scale (PSS-4) [range 0-16, scores ≥6 depicting high stress]. Chronic stress was defined as at least 2 follow-up PSS-4 scores ≥6. We identified and validated this final model in another prospective registry of patients with symptomatic PAD, the PORTRAIT study. RESULTS Our derivation cohort consisted of 4,340 patients with MI (mean age 59.1 ± 12.3 years, 33% females, 30% non-white), of whom 30% had chronic stress at follow-up. Of the 27 factors examined, female sex, current smoking, socioeconomic status, and economic burden due to medical care were positively associated with chronic stress, and ENRICHD Social Support Instrument (ESSI) score and age were inversely related to chronic stress. In the validation cohort of 797 PAD patients (mean age 68.6±9.7 years, 42% females, 28% non-white, 18% chronic stress) the c-statistic for the model was 0.77 and calibration was excellent. CONCLUSIONS We can reliably identify factors that are independently associated with risk of chronic stress in patients with CVD. As chronic stress is associated with worse outcomes in this population, our work identifies potential targets for interventions to as well as the patients that could benefit from these.
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Affiliation(s)
- Ali O. Malik
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - Philip G. Jones
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | | | - Matthew M. Burg
- Yale School of Medicine, New Haven, CO, United States of America
| | | | - Vittal Hejjaji
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - Andy Tran
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - John A. Spertus
- Saint Luke’s’ Mid America Heart Institute, Kansas City, MO, United States of America
- University of Missouri Kansas City, Kansas City, MO, United States of America
| | - Kim G. Smolderen
- Yale School of Medicine, New Haven, CO, United States of America
- * E-mail:
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19
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Effects of financial anxiety and employability on emotional exhaustion and performance. JOURNAL OF VOCATIONAL BEHAVIOR 2022. [DOI: 10.1016/j.jvb.2022.103761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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20
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Agarwal N, Biswas B. Financial literacy and its correlates among healthcare professionals of India: An ignored educational need. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:246. [PMID: 36177428 PMCID: PMC9514280 DOI: 10.4103/jehp.jehp_1129_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 02/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Financial literacy is a person's capability to manage their own monetary matters. There was no information available on financial literacy status of healthcare professionals (HCPs) of India. So, the current research was formulated to assess the financial literacy status and its correlates among HCPs of India. MATERIALS AND METHODS It was an observational study, cross-sectionally designed, conducted among 524 HCPs of India using a structured Google form during July 2020. For data analysis, SPSS (version 22) was used. RESULTS Among the study participants, 68.3% were found to be financially literate. Among the various subdomains of the total financial literacy, knowledge regarding general domain was observed to be the best (69.3%) followed by savings (63.7%) and investment (58.0%) domains, respectively. The total financial literacy score was found to be positively correlated with higher age [spearman rho correlation co-efficient (ρ) = 0.25; P =< 0.01], qualification [(medical postgraduate) (ρ= 0.16; P =< 0.01); (medical super speciality) (ρ = 0.14; P =< 0.01)], and annual family income (ρ= 0.29; P =< 0.01). Moreover, males (ρ= 0.23; P =< 0.01)], currently married (ρ= 0.19; P =< 0.01), and surgeons (ρ= 0.12; P =< 0.01) were found to be more financially literate compared with others. Positive financial attitude (ρ= 0.26; P =< 0.01) and regular maintenance of financial record (ρ= 0.21; P =< 0.01) were the other enabling factors of financial literacy observed in the study. CONCLUSIONS Financial literacy was found to be quite low in the surveyed HCPs as every third study participant were found to be deficient in knowledge regarding one or more financial attributes. Incorporation of finance management in curriculum of the healthcare allied courses and repeated sensitization of the graduated HCPs are warranted to enable them to take effective financial decisions to meet their personal and organizational financial goals.
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Affiliation(s)
- Neeraj Agarwal
- Department Community and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Bijit Biswas
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
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21
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Romo LK, Thompson CM, Ben-Israel P. An Examination of How People Appraise and Manage Health-Related Financial Uncertainty. HEALTH COMMUNICATION 2022; 37:935-943. [PMID: 33541143 DOI: 10.1080/10410236.2021.1876813] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
While health care is one of the largest stressors across all incomes and political affiliations, it is unclear how people with health-related financial uncertainty appraise and manage this ambiguity. Using the lens of Uncertainty Management Theory (UMT) and a thematic analysis of semi-structured, in-depth interviews with 17 individuals facing financial and health struggles, we uncovered how intersecting financial and medical uncertainty exacerbated participants' medical worries, worsening and compromising their mental and physical health. Additionally, we revealed how participants managed health-related financial uncertainty through seeking social support, seeking information to reduce financial burden, enacting financial concessions, making health sacrifices, avoiding information and thoughts about health costs, and adapting to chronic financial uncertainty. This study extends UMT by foregrounding the ways individuals' environmental resources (i.e., limited financial means) can jeopardize tending to their health, illustrating how uncertainty management is connected not only to communication strategies but also to health behaviors, such as tapering or skipping medications or procedures.
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Affiliation(s)
- Lynsey K Romo
- Department of Communication, North Carolina State University
| | | | - Patience Ben-Israel
- Division of Public Health, North Carolina Department of Health and Human Services
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22
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Fernandez JR, Montiel Ishino FA, Williams F, Slopen N, Forde AT. Hypertension and Diabetes Status by Patterns of Stress in Older Adults From the US Health and Retirement Study: A Latent Class Analysis. J Am Heart Assoc 2022; 11:e024594. [PMID: 35699190 PMCID: PMC9238649 DOI: 10.1161/jaha.121.024594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Hypertension and diabetes disproportionately affect older non‐Hispanic Black and Hispanic adults in the United States. Chronic stress may partially explain these disparities. This study identified underlying stress profiles of older US adults, analyzed stress profiles in relation to hypertension and diabetes, examined the distribution of stress profiles by race and ethnicity, and assessed patterns of change in latent classes of stress over time. Methods and Results Latent class analysis was conducted with a nationally representative sample of older US adults who completed 3 waves of the HRS (Health and Retirement Study) (ie, 2010 [n=6863], 2014 [n=4995], and 2018 [n=3089]). Latent classes of stress in 2010 (ie, stress profiles) were identified using 15 indicators of unmet needs within 5 categories (ie, physiological, safety/security, belonging, esteem, and self‐fulfillment). Hypertension and diabetes status were examined as outcomes of latent class membership at 3 time points, and race and ethnicity were examined in association with class membership, adjusting for sociodemographic covariates. Finally, a latent transition analysis examined the stability of latent class membership and racial and ethnic differences in the patterns of stress profiles experienced from 2010 to 2018. Five classes were identified: Generally Unmet Needs (13% of sample), Generally Met Needs (42% of sample), Unmet Self‐Efficacy/Goal Needs (12% of sample), Unmet Financial Needs (20% of sample), and Unmet Social Belonging Needs (13% of sample). Compared with the Generally Met Needs class, the Generally Unmet Needs class had higher odds of hypertension (odds ratio [OR], 1.80; [95% CI, 1.35–2.39]) and diabetes (OR, 1.94; [95% CI, 1.45–2.59]), and the Unmet Financial Needs class had higher odds of diabetes (OR, 1.50; [95% CI, 1.10–2.05]). Non‐Hispanic Black participants compared with non‐Hispanic White participants had higher odds of being members of the Generally Unmet Needs, Unmet Self‐Efficacy/Goal Needs, and Unmet Financial Needs classes (OR, 2.70; [95% CI, 1.59–4.58]; OR, 1.99; [95% CI, 1.15–3.43]; and OR, 4.74; [95% CI, 3.32–6.76], respectively). Class membership remained relatively stable over time, with 93% of participants remaining in Generally Met Needs and 78% of participants remaining in Generally Unmet Needs across time points. Compared with non‐Hispanic White participants, non‐Hispanic Black participants had lower odds of Generally Met Needs class membership at any time point (OR, 0.60; [95% CI, 0.42–0.84]) and had lower odds of moving into the Generally Met Needs class and higher odds of moving into the Unmet Financial Needs class from 2010 to 2014 (OR, 0.33; [95% CI, 0.13–0.86]; and OR, 3.02; [95% CI, 1.16–7.87], respectively). Conclusions Underlying classes of stress based on unmet needs were associated with hypertension and diabetes status. Racial and ethnic differences were observed for both latent class membership and transitions between classes over time. Latent classes of stress associated with unmet needs, hypertension, and diabetes and the ability to transition between classes may explain the perpetuation of racial and ethnic disparities in cardiovascular health. Interventions targeting unmet needs may be used to confront these disparities.
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Affiliation(s)
- Jessica R. Fernandez
- Division of Intramural ResearchNational Institute on Minority Health and Health DisparitiesNational Institutes of HealthBethesdaMD
| | - Francisco A. Montiel Ishino
- Division of Intramural ResearchNational Institute on Minority Health and Health DisparitiesNational Institutes of HealthBethesdaMD
| | - Faustine Williams
- Division of Intramural ResearchNational Institute on Minority Health and Health DisparitiesNational Institutes of HealthBethesdaMD
| | - Natalie Slopen
- Department of Social and Behavioral SciencesHarvard University T. H. Chan School of Public HealthBostonMA
| | - Allana T. Forde
- Division of Intramural ResearchNational Institute on Minority Health and Health DisparitiesNational Institutes of HealthBethesdaMD
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23
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de Vries LP, van de Weijer MP, Bartels M. The human physiology of well-being: A systematic review on the association between neurotransmitters, hormones, inflammatory markers, the microbiome and well-being. Neurosci Biobehav Rev 2022; 139:104733. [PMID: 35697161 DOI: 10.1016/j.neubiorev.2022.104733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/09/2022] [Accepted: 06/07/2022] [Indexed: 02/08/2023]
Abstract
To understand the pathways through which well-being contributes to health, we performed a systematic review according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines on the association between well-being and physiological markers in four categories, neurotransmitters, hormones, inflammatory markers, and microbiome. We identified 91 studies. Neurotransmitter studies (knumber of studies=9) reported only a possible positive association between serotonin and well-being. For the hormone studies (k = 48), a lower momentary cortisol level was related to higher well-being (meta-analytic r = -0.06), and a steeper diurnal slope of cortisol levels. Inflammatory marker studies (k = 36) reported negative or non-significant relations with well-being, with meta-analytic estimates of respectively r = -0.07 and r = -0.05 for C-reactive protein and interleukin-6. Microbiome studies (k = 4) reported inconsistent associations between different bacteria abundance and well-being. The results indicate possible but small roles of serotonin, cortisol, and inflammatory markers in explaining differences in well-being. The inconsistent and limited results for other markers and microbiome require further research. Future directions for a complete picture of the physiological factors underlying well-being are proposed.
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Affiliation(s)
- Lianne P de Vries
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands.
| | - Margot P van de Weijer
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands
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Tee EYJ, Shah RIABRR, Ramis T, Jia-Qi LC. Bent, But Not Broken: Locus-of-Hope and Well-Being Among Malaysians Facing Economic Challenges Amidst the COVID-19 Pandemic. PSYCHOLOGICAL STUDIES 2022; 67:304-316. [PMID: 35601659 PMCID: PMC9110276 DOI: 10.1007/s12646-022-00653-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 02/17/2022] [Indexed: 11/30/2022] Open
Abstract
Hope is conceptualized as a cognitive set that has often been studied in the context of adversity. No studies, however, directly examine how locus-of-hope (LOH) influences psychological outcomes among vulnerable populations within collectivist cultural contexts. We address this gap by assessing the relationships between LOH and well-being among Malaysians facing financial struggles during the COVID-19 pandemic. We hypothesized that LOH will predict well-being but that external LOH will more strongly predict well-being than internal LOH. One-hundred and fifty-two (152) Malaysians (63 men, 89 women, average age 29.69 years old) who have (1) experienced loss of employment status (2) decrease in salary earnings or (3) earn below the lower 40% threshold of national household incomes completed a series of questionnaires assessing their LOH and well-being. Results indicate that controlling for age, perceptions of government efforts and trait optimism, LOH significantly predict well-being. Findings also show that internal LOH and LOH-family were the strongest predictors of well-being. Theoretical and practical implications are discussed in light of these findings.
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Affiliation(s)
- Eugene Y. J. Tee
- Department of Psychology, Faculty of Behavioural Sciences, Languages, and Education, HELP University, Kuala Lumpur, Malaysia
| | | | - TamilSelvan Ramis
- Centre for American Education, Sunway University, Petaling Jaya, Malaysia
| | - Lauren Chai Jia-Qi
- Department of Psychology, Faculty of Behavioural Sciences, Languages, and Education, HELP University, Kuala Lumpur, Malaysia
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Graham-Engeland J, DeMeo NN, Jones DR, Mathur A, Smyth JM, Sliwinski MJ, McGrady ME, Lipton RB, Katz MJ, Engeland CG. Individuals with both higher recent negative affect and physical pain have higher levels of C-reactive protein. Brain Behav Immun Health 2022; 21:100431. [PMID: 35243409 PMCID: PMC8881375 DOI: 10.1016/j.bbih.2022.100431] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/02/2022] Open
Abstract
Conceptualizing physical pain and negative affect as potentially interactive, we hypothesized that higher levels of peripheral inflammatory markers would be observed consistently only among individuals with both higher negative affect and pain symptomatology. Participants were generally healthy midlife adults from the Bronx, NY (N = 212, Mage = 46.77; 60.8% Black, 25.5% Hispanic/Latina/o) recruited as part of a larger study. Key measures were: reported pain intensity and pain interference at baseline, recent negative affect averaged from self-reports 5x/day for 7 days, and peripheral inflammatory markers (C-reactive protein [CRP] and a composite cytokine measure based on seven cytokines). Controlling for age, BMI, gender, and education, recent negative affect significantly interacted with both pain variables to explain variance in CRP, with higher CRP levels observed only in individuals with both higher negative affect and either higher pain intensity or pain interference. These findings contribute to an emerging literature suggesting that negative affect, pain, and inflammation are related in important and complex ways.
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Wilson D, Rodrigues de Oliveira D, Palace-Berl F, de Mello Ponteciano B, Fungaro Rissatti L, Piassa Pollizi V, Sardela de Miranda F, D'Almeida V, Demarzo M. Fostering emotional self-regulation in female teachers at the public teaching network: A mindfulness-based intervention improving psychological measures and inflammatory biomarkers. Brain Behav Immun Health 2022; 21:100427. [PMID: 35243406 PMCID: PMC8881415 DOI: 10.1016/j.bbih.2022.100427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To examine the effect of a mindfulness-based program specifically designed for teachers in reducing perceived stress and improving the quality of experienced emotion in female active working teachers. A second outcome evaluated is the associated change in cellular inflammatory activity, measured by peripheral blood levels of cytokines. METHOD Eighty-eight female active teachers from public schools from São Paulo Municipality were recruited, and randomly allocated to an eight-week Mindfulness-Based Health Program for Educators (MBHP-Educa) or to Neuroscience for Education Program (Neuro-Educa: active control group). The venue of both programs were several public school facilities, where many of the teachers actually worked. Both groups received activities during eight weeks in a 2 h/week regimen, totalizing 16 h. Sixty-five participants completed the program and pre- and post-interventions measures were taken from the following scales: Interpersonal Multidimensional Reactivity Scale (IRI), Positive-and-Negative Affects Scale (PANAS), Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RISC), and a primary outcome in Ryff's Psychological Well-Being Scale (PBWS). At pre-and post-intervention, blood samples were collected for the measurement of several important inflammatory biomarkers, Tumor Necrosis Factor - α (TNF-α), Interleukin 1β (IL-1β), Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10) and Interleukin 12p70 (IL-12P70) through flow cytometry assay. Intervention effects were analyzed via Generalized mixed models (GLMM). RESULTS According to the GLMM, MBHP-Educa significantly reduced the scores of perceived stress (p < 0.0001), and negative affect (p < 0.0001) compared to active control group (Neuro-Educa). Conversely, an increase was observed on Psychological Well Being Scale in dimensions of Self-acceptance (p < 0.0001), and Autonomy (p = 0.001), as well as improvements in Resilience (p < 0.0001), and Positive Affect (p < 0.0001). MBHP-Educa also promoted a reduction in the levels of IL-6 (p = 0.003), IL-8 (p = 0.036), and increase in the levels of IL-10 (p < 0.0001) and IL-12p70 (p < 0.044). TNF-α, IL-1β, and IL-10p70 showed results below theoretical limit of detection accepted for CBA kit. CONCLUSIONS Our data suggest that mindfulness-based interventions introduced as a strategy for reducing stress, promoting well-being and improve immune function can be a useful asset in promoting psychological health among teachers in Basic Education.
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Affiliation(s)
- David Wilson
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Daniela Rodrigues de Oliveira
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Laboratory of Medical Investigation (LIM-26), Department of Surgery, University of Sao Paulo Medical School, São Paulo, SP, Brazil
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Fanny Palace-Berl
- Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Laboratory of Medical Investigation (LIM-26), Department of Surgery, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Bárbara de Mello Ponteciano
- Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Luciana Fungaro Rissatti
- Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Valéria Piassa Pollizi
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Flávia Sardela de Miranda
- Laboratory of Imunomodulation, Department of Imunology, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vânia D'Almeida
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Marcelo Demarzo
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion, Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Hunt C, Mun CJ, Owens M, Lerman S, Kunatharaju S, Tennen H, Buenaver L, Campbell C, Haythornthwaite J, Smith M, Finan PH. Sleep, Positive Affect, and Circulating Interleukin-6 in Women With Temporomandibular Joint Disorder. Psychosom Med 2022; 84:383-392. [PMID: 35067649 PMCID: PMC8976725 DOI: 10.1097/psy.0000000000001047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Systemic inflammation is commonly observed in idiopathic chronic pain conditions, including temporomandibular joint disorder (TMD). Trait positive affect (PA) is associated with lower inflammation in healthy controls, but those effects may be threatened by poor sleep. The associations between PA with proinflammatory cytokine activity and potential moderation by sleep in chronic pain are not known. We thus investigated the association between PA and circulating interleukin-6 (IL-6) and moderation of that association by sleep in a sample of women with TMD and sleep difficulties. METHODS Participants (n = 110) completed the insomnia severity index and provided blood samples at five intervals throughout an evoked pain testing session. They then completed a 14-day diary assessing sleep and affect, along with wrist actigraphy. RESULTS There was not a significant main effect of PA on resting or pain-evoked IL-6 (b = 0.04, p = .33). Diary total sleep time (b = -0.002, p = .008), sleep efficiency (b = -0.01, p = .005), sleep onset latency (b = 0.006, p = .010), and wake after sleep onset (b = 0.003, p = .033) interacted with PA to predict IL-6, such that PA inversely predicted IL-6 at higher levels of total sleep time and sleep efficiency and at lower levels of sleep onset latency and wake after sleep onset. Surprisingly, when sleep was poor, PA predicted greater IL-6. CONCLUSIONS The potential salutary effects of PA on resting IL-6 erode when sleep is poor, underscoring the importance of considering sleep in conceptual and intervention models of TMD.
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Affiliation(s)
- Carly Hunt
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Chung Jung Mun
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Michael Owens
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Sheera Lerman
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Shriya Kunatharaju
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | | | - Luis Buenaver
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Claudia Campbell
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Jennifer Haythornthwaite
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Michael Smith
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
| | - Patrick H. Finan
- Johns Hopkins University School of Medicine, Department of Psychiatry, Division of Behavioral Medicine
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Crandall AK, McKay NJ, Khan AM, Lantyer MC, Temple JL. The effect of acute and chronic scarcity on acute stress: A dyadic developmental examination. Physiol Behav 2022; 246:113684. [PMID: 34929257 PMCID: PMC8821326 DOI: 10.1016/j.physbeh.2021.113684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Food insecurity, obesity, and psychological stress are interrelated constructs which are thought to be connected through increased energy intake, but the underlying mechanisms for these relationships remain unclear. The current study used experimental methods to investigate how financial losses may influence acute stress in the context of food insecurity for both parents and offspring. This study also sought to examine the effect of acute stress related to financial losses on the reinforcing value of food (RRVfood) and delay discounting (DD). METHODS One hundred and six families stratified by both offspring age (53 children aged 7-10, 53 adolescents aged 15-17) and household financial resources, visited our laboratory for three separate appointments. Each appointment included the experimental manipulation of financial gains and losses, saliva samples for cortisol assay, continuous heart rate monitoring, self-rated tension, and computer-based DD and RRVfood tasks. Participants also completed surveys to report perceived life stress level and food insecurity status. RESULTS Among all participants, financial losses were related to decreased heart rates and increased self-rated tension. Among parents reporting food insecurity, acute financial losses resulted in an increase in cortisol levels. Changes in cortisol, heart rate, and tension were not related to RRVfood or DD. CONCLUSION Food insecure parents are sensitive to financial losses and respond with an increase in cortisol. However, we found no evidence for a relationship between cortisol and RRVfood or DD. This sensitivity to financial losses did not extend to children or adolescents.
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Affiliation(s)
- Amanda K Crandall
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214.
| | - Naomi J McKay
- Department of Psychology, SUNY Buffalo State, Buffalo, NY 14222
| | - Ali M Khan
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214
| | - Maria Catharina Lantyer
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214
| | - Jennifer L Temple
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214; Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214
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McCann L, Thompson SC, Rolf F, Podubinski T. Police, permits and politics: Navigating life on Australia's state borders during the COVID-19 pandemic. Aust J Rural Health 2022; 30:363-372. [PMID: 35229397 PMCID: PMC9111201 DOI: 10.1111/ajr.12845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 12/09/2021] [Accepted: 01/11/2022] [Indexed: 01/03/2023] Open
Abstract
Objective To explore the ways in which the Coronavirus disease‐19 (COVID‐19) pandemic has affected Australians who live and travel in cross‐border regions in the course of their daily lives. Design Semi‐structured interviews were undertaken with participants by telephone. The analysis utilised qualitative exploratory methods and provided rich data through immersive and reflexive analysis. Setting Interviews of people across Australia. Participants Of 90 people interviewed in relation to their experiences of the COVID‐19 pandemic, 13 described challenges related to border crossing that impacted their usual work and personal life. Main outcome Measure Description of challenges faced by Australians living close to state borders due to internal border closures in the early period of COVID‐19 (2020). Results Policy changes surrounding border closures negatively impacted people’s wellbeing in Australia with three key interconnected themes identified for Australians living in cross‐border regions. First, border closures presented participants of these communities with physical barriers which reduced access to healthcare and employment. Second, participants reported how restrictions on travel to neighboring states and territories impacted their mental wellbeing. Finally, many Australians in cross‐border regions faced financial struggles exacerbated by border closures. Conclusion Normally, interstate borders are largely invisible with formalities relevant to few circumstances. Since the emergence of the COVID‐19 pandemic, Australians who used to regularly cross these borders in the course of their daily activities were no longer able or willing to do so due to the uncertain circumstances surrounding border policy. This study elaborates on the impact of these closures on people’s physical, financial, and emotional state.
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Affiliation(s)
- Lily McCann
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
| | - Floraidh Rolf
- Southern Queensland Rural Health, University of Queensland, Charleville, Queensland, Australia
| | - Tegan Podubinski
- Department of Rural Health, University of Melbourne, Melbourne, Victoria, Australia
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Problematic anger and economic difficulties: Findings from the Millennium Cohort Study. J Affect Disord 2022; 297:679-685. [PMID: 34710505 DOI: 10.1016/j.jad.2021.10.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/06/2021] [Accepted: 10/23/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND The role of problematic anger in relation to economic difficulties is not well understood. This study examined the association of problematic anger with 4 elements of economic difficulties among service members and veterans. METHODS Study participants (n = 95,895) were from the Millennium Cohort Study, and included U.S. service members and veterans; analyses were restricted to a Reserve/National Guard and/or veteran sample as appropriate. Key measures included the Dimensions of Anger Reactions scale and self-reported economic variables (involuntary job loss, financial problems, unemployment and homelessness). Covariates included demographics, military characteristics, disabling injury or illness, problem drinking, posttraumatic stress disorder, and major depressive disorder. The study design was cross-sectional. RESULTS Among all participants, 17.4% screened positive for problematic anger, 29.7% reported involuntary job loss, and 6.4% reported financial problems. After adjustment for covariates, problematic anger was associated with involuntary job loss (AOR=1.28; 95% CI: 1.22, 1.33) and financial problems (AOR=1.46; 95% CI: 1.36, 1.57). Among veterans, 12.1% reported being unemployed; among Reserve/National Guard and veterans, 2.3% reported homelessness. Problematic anger was associated with unemployment (AOR=1.28, 95% CI: 1.18, 1.37) and homelessness (AOR=1.33; 95% CI: 1.16, 1.52) after adjusting for covariates. LIMITATIONS The study relied on self-report data and directionality could not be established. CONCLUSIONS Problematic anger was significantly associated with involuntary job loss, financial problems, unemployment and homelessness, even after adjusting for relevant covariates. These findings have clinical relevance in demonstrating the potential for targeting problematic anger in service members and veterans.
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Passias PG, Ahmad W, Kummer N, Lafage R, Lafage V, Kebaish K, Daniels A, Klineberg E, Soroceanu A, Gum J, Line B, Hart R, Burton D, Eastlack R, Jain A, Smith JS, Ames CP, Shaffrey C, Schwab F, Hostin R, Bess S. Examination of the Economic Burden of Frailty in Patients With Adult Spinal Deformity Undergoing Surgical Intervention. Neurosurgery 2022; 90:148-153. [PMID: 34982882 DOI: 10.1227/neu.0000000000001756] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/24/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND With increasing interest in cost optimization, costs of adult spinal deformity (ASD) surgery intersections with frailty merit investigation. OBJECTIVE To investigate costs associated with ASD and frailty. METHODS Patients with ASD (scoliosis ≥20°, sagittal vertical axis [SVA] ≥5 cm, pelvic tilt ≥ 25°, or thoracic kyphosis ≥ 60°) with baseline and 2-yr radiographic data were included. Patients were severely frail (SF), frail (F), or not frail (NF). Utility data were converted from Oswestry Disability Index to Short-Form Six-Dimension. Quality-adjusted life years (QALYs) used 3% rate for decline to life expectancy. Costs were calculated using PearlDiver. Loss of work costs were based on SRS-22rQ9 and US Bureau of Labor Statistics. Accounting for complications, length of stay, revisions, and death, cost per QALY at 2 yr and life expectancy were calculated. RESULTS Five hundred ninety-two patients with ASD were included (59.8 ± 14.0 yr, 80% F, body mass index: 27.7 ± 6.0 kg/m2, Adult Spinal Deformity-Frailty Index: 3.3 ± 1.6, and Charlson Comorbidity Index: 1.8 ± 1.7). The average blood loss was 1569.3 mL, and the operative time was 376.6 min, with 63% undergoing osteotomy and 54% decompression. 69.3% had a posterior-only approach, 30% combined, and 0.7% anterior-only. 4.7% were SF, 22.3% F, and 73.0% NF. At baseline, 104 were unemployed losing $971.38 weekly. After 1 yr, 62 remained unemployed losing $50 508.64 yearly. With propensity score matching for baseline SVA, cost of ASD surgery at 2 yr for F/SF was greater than that for NF ($81 347 vs $69 722). Cost per QALY was higher for F/SF at 2 yr than that for NF ($436 473 vs $430 437). At life expectancy, cost per QALY differences became comparable ($58 965 vs $58 149). CONCLUSION Despite greater initial cost, F and SF patients show greater improvement. Cost per QALY for NF and F patients becomes similar at life expectancy.
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Affiliation(s)
- Peter G Passias
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
- Department of Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
| | - Waleed Ahmad
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
- Department of Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
| | - Nicholas Kummer
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
- Department of Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
| | - Renaud Lafage
- Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA
| | - Virginie Lafage
- Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA
- Department of Orthopaedics, Lenox Hill Hospital, Northwell Health, New York, NY, USA
| | - Khaled Kebaish
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
- Department of Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
| | - Alan Daniels
- Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Eric Klineberg
- Department of Orthopaedic Surgery, University of California, Davis, Davis, California, USA
| | - Alex Soroceanu
- Department of Orthopedics, University of Calgary, Calgary, Canada
| | - Jeffrey Gum
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
| | - Breton Line
- Department of Spine Surgery, Denver International Spine Clinic, Presbyterian St. Luke's/Rocky Mountain Hospital for Children, Denver, Colorado, USA
| | - Robert Hart
- Department of Orthopaedic Surgery, Swedish Neuroscience Institute, Seattle, Washington, USA
| | - Douglas Burton
- Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Robert Eastlack
- Division of Orthopaedic Surgery, Scripps Clinic, La Jolla, California, USA
| | - Amit Jain
- Department of Neurologic Surgery, Johns Hopkins Medical Center, Baltimore, Maryland, USA
| | - Justin S Smith
- Department of Orthopedics, University of Calgary, Calgary, Canada
| | - Christopher P Ames
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA
- Norton Leatherman Spine Center, Louisville, Kentucky, USA
| | - Christopher Shaffrey
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA
- Department Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Frank Schwab
- Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA
- Department of Orthopaedics, Lenox Hill Hospital, Northwell Health, New York, NY, USA
| | - Richard Hostin
- Department of Orthopaedic Surgery, Baylor Scoliosis Center, Dallas, Texas, USA
| | - Shay Bess
- Department of Spine Surgery, Denver International Spine Clinic, Presbyterian St. Luke's/Rocky Mountain Hospital for Children, Denver, Colorado, USA
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Brennan CL, Borgman RA, Watts SS, Wilson RA, Swartout KM. Childhood Neglect History, Depressive Symptoms, and Intimate Partner Violence Perpetration by College Students. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP12576-NP12599. [PMID: 31984831 DOI: 10.1177/0886260519900307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
College students experience intimate partner violence (IPV) at an alarming rate, and preventing such violence depends on identifying factors that contribute to perpetration. Although there is extensive research that has established a link between childhood neglect and later physical IPV perpetration, less is known about the specific mechanisms through which childhood neglect leads to IPV perpetration. In the present study, we examined potential mediators of the relationship between childhood neglect and IPV perpetration by college students, with special emphasis on the role of depressive symptoms and IPV victimization. A total of 302 college students reported on their experiences of childhood maltreatment, depressive symptoms, and IPV victimization and perpetration. Results indicate that increasing levels of childhood emotional and physical neglect correspond with increasing rates of IPV perpetration, after accounting for the effect of childhood emotional, physical, and sexual abuse. This effect between childhood neglect and IPV perpetration was fully mediated by the combination of IPV victimization and depressive symptoms for the overall sample. However, when examining the model for men and women separately, only the indirect effect through victimization remained statistically significant for men. Our findings suggest that research on the link between childhood neglect and IPV perpetration should also consider the impact of IPV victimization, as neglect may lead to IPV perpetration within the context of a mutually aggressive relationship. Furthermore, these findings indicate that childhood neglect leads to long-term emotional consequences that contribute to later IPV perpetration, and treating depressive symptoms may help prevent IPV perpetration against college students who experienced childhood neglect.
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Association of Baseline Patient-reported Health-related Quality of Life Metrics with Outcome in Localised Prostate Cancer. Clin Oncol (R Coll Radiol) 2021; 34:e61-e68. [PMID: 34728131 DOI: 10.1016/j.clon.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/13/2021] [Accepted: 10/14/2021] [Indexed: 11/22/2022]
Abstract
AIMS Although health-related quality of life (HR-QoL) outcomes are pivotal in oncology, the prognostic significance of patient-reported HR-QoL metrics is largely undefined in localised prostate cancer. We report the association of baseline HR-QoL metrics with overall survival and toxicity in localised prostate cancer. MATERIALS AND METHODS This was a secondary analysis of a phase III randomised controlled study conducted in a single-payer health system. Patients with Gleason score ≤7, clinical stage T1b-T3a and prostate-specific antigen <30 ng/ml were randomised to neoadjuvant and concurrent androgen deprivation therapy (ADT) for 6 months starting 4 months before prostate radiotherapy or concurrent and adjuvant ADT for 6 months starting simultaneously with prostate radiotherapy. HR-QoL scores were estimated using the European Organisation for Research and Treatment of Cancer QoL questionnaire. A multistate Markov model was used to determine the association of baseline HR-QoL metrics with overall survival and a multilevel multivariable Cox regression was used to determine the association with the incidence of delayed-onset grade ≥3 radiotherapy-related toxicities. To adjust for multiple analyses, P < 0.025 was considered as statistically significant. RESULTS Overall, 393 patients with baseline HR-QoL data were included in this analysis: 194 in the neoadjuvant arm and 199 in the adjuvant arm. Baseline financial difficulty (hazard ratio 1.020, 95% confidence interval 1.010-1.030, P = 0.02) and dyspnoea (hazard ratio 1.020, 95% confidence interval 1.003-1.030, P = 0.01) were associated with inferior overall survival. Baseline dyspnoea was associated with a higher incidence of grade ≥3 toxicity (hazard ratio 1.020, 95% confidence interval 1.010-1.030, P = 0.023). CONCLUSION In a cohort of localised prostate cancer patients treated with radiotherapy and short-term ADT, a 10-point higher baseline financial difficulty or dyspnoea was associated with a 20% increased risk of death. With each 10-point increase in baseline dyspnoea, we noted a 20% increase in the associated risk of grade ≥3 delayed-onset radiotherapy-related toxicity.
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Leisure Time Satisfaction and Activity Preferences Among Ethnically Diverse Aging Parents in Metro Vancouver. J Cross Cult Gerontol 2021; 36:387-406. [PMID: 34550533 DOI: 10.1007/s10823-021-09440-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
It is well established that family and work-retirement transitions are increasingly becoming more complicated, extended, and reversible among aging parents. Combined with improved life expectancy, older parents are now confronted with new opportunities and challenges including their access to leisure activities. However, a paucity of research exists with regard to the extent to which older-aged parents are satisfied with their amount of leisure time as well as their ideal leisure preferences. Drawing upon socio-cultural life course theory, this paper examines how socio-demographic and ethnocultural variables (i.e., gender, ethnic identity), family-related factors (e.g., presence of children in the household), and socio-economic and work contexts (i.e., income satisfaction and retirement status) shape leisure time satisfaction and activity preferences. Data are drawn from the "Families and Retirement Project," a sample of 588 diverse (British-, Chinese-, Iranian/Persian-, South-Asian Canadians) aged 50 + (mean age = 59.6) residing in Metro Vancouver with at least one young adult child aged 19-35. Quantitative analyses reveal that leisure time satisfaction is higher among: those reporting lower levels of parental stress, the fully retired, those with less education, and among Chinese parents (compared to British). Moreover, strong variations by ethnic background are shown in preferred leisure activity, based on a thematic analysis of data. Results are discussed in terms of contributions to a socio-cultural family life course activity theory. Implications for community service provision (e.g., culturally sensitive and relevant recreational programs and services) are also highlighted, given the salience of participation in enjoyable leisure activities to healthy aging.
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Blanchette JE, Toly VB, Wood JR. Financial stress in emerging adults with type 1 diabetes in the United States. Pediatr Diabetes 2021; 22:807-815. [PMID: 33887095 DOI: 10.1111/pedi.13216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/11/2021] [Accepted: 04/06/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe the relationships among financial stress factors (perceived stress, financial stress, and financial independence) and psychological factors (depressive symptoms, trait anxiety, and diabetes distress) on self-management outcomes (HbA1c and diabetes-related quality of life) in emerging adults with type 1 diabetes. RESEARCH DESIGN AND METHODS A descriptive, correlational, cross-sectional study examined 413 emerging adults, ages 18-25, from the Type 1 Diabetes Exchange Clinic Registry. Data were collected via REDCap surveys using the Personal Financial Well-Being Scale, Willingness to Pay Scale, Financial Independence Visual Analog Scale, Center for Epidemiological Studies-Depression Inventory, State-Trait Anxiety Inventory, The Type 1 Diabetes Distress Scale, and Diabetes Quality of Life Measure. Hierarchical Multiple Regression analyses explored significant barriers to self-management outcomes. RESULTS Hierarchical Multiple Regression analyses revealed that 20.6% of variance in HbA1c (F = 15.555, p < 0.001) was explained by greater financial stress (β = -0.197, p < 0.001), willingness to pay (β = -0.220, p < 0.001), disease duration (β = 0.119, p = 0.014), and diabetes distress (β = 0.181, p < 0.001); 64.5% of the variance in diabetes-related quality of life (F = 148.469, p < 0.001) was significantly explained by greater financial stress (β = -0.112, p = 0.002), diabetes distress (β = 0.512, p < 0.001), trait anxiety (β = 0.183, p = 0.001) and depressive symptoms (β = 0.162, p = 0.001). CONCLUSIONS Greater financial stress and psychological factors have detrimental impacts on self-management outcomes during emerging adulthood. Diabetes providers need to identify and address these factors in routine care and advocate for policy changes to support improved self-management outcomes.
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Affiliation(s)
- Julia E Blanchette
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Valerie B Toly
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jamie R Wood
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Division of Pediatric Endocrinology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
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Hunt CA, Smith MT, Mun CJ, Irwin MR, Finan PH. Trait positive affect buffers the association between experimental sleep disruption and inflammation. Psychoneuroendocrinology 2021; 129:105240. [PMID: 33975149 PMCID: PMC8314429 DOI: 10.1016/j.psyneuen.2021.105240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Sleep disturbances and insufficient sleep are highly prevalent. Both clinical sleep disorders and multiple forms of experimental sleep loss predict heightened inflammation. As such, it is necessary to investigate potential protective factors. Given that trait positive affect (PA) is associated with reduced inflammation, and buffers the proinflammatory effects of stress, it is possible that high trait positive affect might protect individuals from an inflammatory response to sleep disruption. The present study tested this hypothesis in an experimental sleep disruption paradigm with assessment of cellular inflammation. METHODS Data were drawn from good sleeping adults (n = 79) who participated in a randomized, within-subjects crossover experiment comparing the effects of two nights of sleep disruption versus two nights of uninterrupted sleep. Stimulated monocytic production of intracellular proinflammatory cytokines tumor necrosis factor (TNF) and interleukin-6 (IL-6) were assayed using flow cytometric methods and indexed as the percentage of monocytes expressing TNF, IL-6, or co-expressing both. Hypotheses were evaluated using linear mixed effects models. RESULTS Controlling for negative affect, body mass index, age, and sex, PA significantly moderated the associations between sleep condition and stimulated monocyte production of IL-6 (b = -1.03, t = -2.02, p = .048) and its co-expression with TNF (b = -0.93, t = -2.00, p = .049), such that inflammatory responses were blunted among those high in PA with increases principally among those low in PA. The effect on TNF was similar in terms of effect size, but marginally significant. CONCLUSIONS Activation of cellular inflammation in response to sleep disruption is buffered by PA independent of negative affect. Interventions that promote PA might protect persons from the inflammatory activation following sleep loss, with the potential to mitigate the adverse health consequences of sleep disturbance.
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Affiliation(s)
- Carly A. Hunt
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael T. Smith
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chung Jung Mun
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael R. Irwin
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Patrick H. Finan
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Community-dwelling older adults who are low-income and disabled weathering financial challenges. Geriatr Nurs 2021; 42:901-907. [PMID: 34098443 DOI: 10.1016/j.gerinurse.2021.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/20/2022]
Abstract
Despite interventions aiming to improve outcomes among older adults experiencing financial challenges, the challenges and strategies employed to handle them are poorly understood. This study examined the experiences of financial challenges among low-income adults aged ≥65 years. Eleven semi-structured interviews were analyzed using thematic analyses. An overarching theme was "I guess it balances", capturing attempts to maintain hope and proactively address challenges despite stress, uncertainty and limitations. Balancing was demonstrated within four domains, including cognitive bandwidth ("think a lot" versus "I don't dwell on that"), emotional experience ("depressing" versus "be thankful"), learned resilience ("that was a shock" versus "there's always a way"), and meeting daily needs ("we learned to do without" versus "take a dollar and stretch it"). Participants described being weathered by challenges and using predominately high-effort coping strategies to weather the challenges. These findings call for strengthening the safety net for older adults facing financial challenges.
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Mohammadi H, Karimifar M, Heidari Z, Zare M, Amani R. The effects of wheat germ consumption on mental health and brain-derived neurotrophic factor in subjects with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Nutr Neurosci 2021; 25:46-53. [PMID: 33983107 DOI: 10.1080/1028415x.2019.1708032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Herbals, as bioactive foods, have been one of the most popular alternatives and complementary treatments in preventing and controlling type 2 diabetes mellitus (T2DM). The aim of the present trial was to examine the effects of wheat germ consumption on mental health and brain-derived neurotrophic factor (BDNF) among patients with T2DM.Methods: Eighty participants with T2DM were randomly allocated to receive 20 g wheat germ (n = 40) or placebo (n = 40) in a randomized double-blind clinical trial for 12 weeks. Depression, anxiety, stress scale-21 (DASS-21) questionnaire was used to assess the mental health of study participants. Serum BDNF was assessed at the baseline and end of intervention. Anthropometric indices were measured at the baseline, 6 and 12 weeks during the intervention.Results: A total of 75 subjects completed the trial. Compared with the placebo, wheat germ consumption led to a significant reduction in depression (P = .03) and stress (P = .04) scores. Moreover, a significant increase in serum BDNF concentrations was observed in the wheat germ group (P = .004), while there was no significant difference between the groups. Wheat germ intake had no significant effects on anthropometric indices and anxiety scores between the groups.Conclusion: Our findings showed that wheat germ consumption for 12 weeks could significantly reduce the stress and depression scores but had no significant effects on anxiety scale and anthropometric outcomes in patients with T2DM.
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Affiliation(s)
- Hamed Mohammadi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mozhgan Karimifar
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Zare
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Physical Aggression and Coronary Artery Calcification: A North Texas Healthy Heart Study. Int J Behav Med 2021; 29:14-24. [PMID: 33880713 DOI: 10.1007/s12529-021-09989-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The purpose of this study was to determine the association between aspects of hostility and coronary artery calcification (CAC) scores. Specifically, analyses differentiated between subtypes of hostility and their relation to CAC. METHODS A sample of 571 patients aged 45 or older with no history of cardiovascular disease completed assessments of demographic, psychosocial, and medical history, along with a radiological CAC determination. Logistic regression was used to determine the association between hostility and CAC. Hostility was measured using the Aggression Questionnaire, which measured total aggression and how aggression is manifested on four scales: Physical, Verbal, Anger, and Hostility Aggression. RESULTS Regression analyses indicated that only the physical aggression parameter was related to CAC: a 5% increase in odds of CAC presence was indicated for every point increase in physical aggression. The association remained significant in adjusted analyses. Other factors associated with CAC in adjusted analyses included: age, gender, race/ethnicity, BMI, and dyslipidemia. CONCLUSIONS Psychosocial factors, such as physical aggression, are emerging factors that need to be considered in cardiovascular risk stratification.
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Occhipinti JA, Skinner A, Freebairn L, Song YJC, Ho N, Lawson K, Lee GY, Hickie IB. Which Social, Economic, and Health Sector Strategies Will Deliver the Greatest Impacts for Youth Mental Health and Suicide Prevention? Protocol for an Advanced, Systems Modelling Approach. Front Psychiatry 2021; 12:759343. [PMID: 34721120 PMCID: PMC8548722 DOI: 10.3389/fpsyt.2021.759343] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Current global challenges are generating extensive social disruption and uncertainty that have the potential to undermine the mental health, wellbeing, and futures of young people. The scale and complexity of challenges call for engagement with systems science-based decision analytic tools that can capture the dynamics and interrelationships between physical, social, economic, and health systems, and support effective national and regional responses. At the outset of the pandemic mental health-related systems models were developed for the Australian context, however, the extent to which findings are generalisable across diverse regions remains unknown. This study aims to explore the context dependency of systems modelling insights. Methods: This study will employ a comparative case study design, applying participatory system dynamics modelling across eight diverse regions of Australia to answer three primary research questions: (i) Will current regional differences in key youth mental health outcomes be exacerbated in forward projections due to the social and economic impacts of COVID-19?; (ii) What combination of social policies and health system strengthening initiatives will deliver the greatest impacts within each region?; (iii) To what extent are optimal strategic responses consistent across the diverse regions? We provide a detailed technical blueprint as a potential springboard for more timely construction and deployment of systems models in international contexts to facilitate a broader examination of the question of generalisability and inform investments in the mental health and wellbeing of young people in the post COVID-19 recovery. Discussion: Computer simulation is known as the third pillar of science (after theory and experiment). Simulation allows researchers and decision makers to move beyond what can be manipulated within the scale, time, and ethical limits of the experimental approach. Such learning when achieved collectively, has the potential to enhance regional self-determination, help move beyond incremental adjustments to the status quo, and catalyze transformational change. This research seeks to advance efforts to establish regional decision support infrastructure and empower communities to effectively respond. In addition, this research seeks to move towards an understanding of the extent to which systems modelling insights may be relevant to the global mental health response by encouraging researchers to use, challenge, and advance the existing work for scientific and societal progress.
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Affiliation(s)
- Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW, Australia
| | - Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Louise Freebairn
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Nicholas Ho
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Kenny Lawson
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Grace Yeeun Lee
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ian B Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Jones DR, Graham-Engeland JE. Positive affect and peripheral inflammatory markers among adults: A narrative review. Psychoneuroendocrinology 2021; 123:104892. [PMID: 33130406 PMCID: PMC8996369 DOI: 10.1016/j.psyneuen.2020.104892] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/10/2020] [Accepted: 09/14/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Previous research suggests that positive affect (PA) may promote health and longevity and that one potential mechanism involves inflammation. However, it remains unclear to what extent PA is associated with specific inflammatory markers and whether such associations are driven by main effects of PA and/or due to PA operating as a stress-buffer. METHODS The present narrative review incorporates studies (N = 28) that have examined the association between PA and peripheral inflammatory markers obtained using venous puncture or dried blood spots. We separate results by whether the study tested direct effects or stress-buffering, and by type of inflammatory marker [including C-reactive protein (CRP), and proinflammatory and anti-inflammatory cytokines], also paying close attention to type of PA assessment (state, aggregated state, or retrospective, the latter involving recall over one to two weeks), and study design (cross-sectional, longitudinal, and experimental). RESULTS Limited evidence suggests that studies were more supportive of a stress-buffering association, compared to a relatively direct association. When significant direct associations were observed, results suggested that studies using measures of state/aggregated PA exhibited more consistent associations with inflammatory markers than studies using retrospective PA. When significant, higher PA tended to be associated with lower pro- and anti-inflammatory markers, suggestive of lower overall inflammatory load. DISCUSSION Recommendations for the field and future research are discussed, including the value of utilizing state/aggregated PA measures and of examining stress-buffering mechanisms.
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Affiliation(s)
- Dusti R Jones
- Department of Biobehavioral Health, The Pennsylvania State University, United States; The Center for Healthy Aging, The Pennsylvania State University, United States.
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Gany F, Mirpuri S, Kim SY, Narang B, Ramirez J, Roberts-Eversley N, Ocampo A, Aragones A, Leng J. Predictors of Health Insurance, Life Insurance, and Retirement Savings Among NYC's Immigrant Taxi and For-Hire Vehicle Drivers. J Community Health 2020; 45:1098-1110. [PMID: 32803621 PMCID: PMC7429200 DOI: 10.1007/s10900-020-00903-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Taxi and for-hire vehicle (FHV) drivers are a predominantly immigrant population facing a range of occupational stressors, including lack of workplace benefits and increasing financial strain from tumultuous industry changes and now COVID-19's devastating impact. Bilingual research staff surveyed 422 New York City taxi/FHV drivers using a stratified sampling approach in driver-frequented locations to examine drivers' health and financial planning behaviors for the first time. Drivers lacked health insurance at double the NYC rate (20% vs. 10%). Life insurance and retirement savings rates were lower than U.S. averages (20% vs. 60%, 25% vs. 58%, respectively). Vehicle ownership was a significant predictor of health insurance, life insurance, and retirement savings. Compared to South Asian drivers, Sub-Saharan African drivers were significantly less likely to have health insurance and North African, and Middle Eastern drivers were significantly less likely to have retirement savings. Although most drivers indicated the importance of insurance and benefits, < 50% understood how to use them. Drivers felt primary care coverage to be most important followed by other health-related coverage, retirement benefits, and life insurance. Results reveal compelling addressable gaps in insurance and benefits coverage and the need to implement accessible financial literacy with navigation and advising services and programs.
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Affiliation(s)
- Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA.
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA.
| | - Sheena Mirpuri
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Soo Young Kim
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Julia Ramirez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Nicole Roberts-Eversley
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Alex Ocampo
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Abraham Aragones
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
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Viljoen C, Lowies B, Lushington K, McGreal S. Female perspectives on housing quality and household characteristics, perceptions and challenges: Evidence from Australia. HABITAT INTERNATIONAL 2020; 105:102276. [PMID: 33071415 PMCID: PMC7552981 DOI: 10.1016/j.habitatint.2020.102276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/25/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023]
Abstract
Electroplated composite Au/SiO2 coatings on a nickel substrate have been produced by dispersing an emulsion of silica nanoparticles (20 nm in diameter) in an industrial hard-gold bath. The tribological behaviour of the Au/SiO2 coatings with different SiO2 content were investigated under sliding conditions against an alumina counterpart at different loads and sliding velocities. The tribological induced transformation of the coated surfaces were analysed using 3D-profilometry, scanning electron microscopy (SEM), focused-ion beam (FIB) cross sectioning and Auger electron epectroscopy (AES). The composite coatings provide higher hardness and ten-fold longer lubricating lifetime compared to the original hard gold coating. Hardness was identified as a key factor reducing the adhesive component of friction and increasing the resistance of gold against smearing. These effects allow to postpone the exposure of the nickel substrate and thus the loss of the self-lubricating character of the coating.
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Affiliation(s)
- Christa Viljoen
- University of South Australia Business, University of South Australia, 37-44 North Terrace, Adelaide, 5000, Australia
| | - Braam Lowies
- University of South Australia Business, University of South Australia, 37-44 North Terrace, Adelaide, 5000, Australia
- Department of Financial Management, Faculty of Economic and Management Sciences, University of Pretoria, Lynnwood Road, Pretoria, 0002, South Africa
| | - Kurt Lushington
- University of South Australia Justice and Society, University of South Australia, St Bernards Road, Magill, 5072, Australia
| | - Stanley McGreal
- University of South Australia Business, University of South Australia, 37-44 North Terrace, Adelaide, 5000, Australia
- Built Environment Research Institute, University of Ulster, Jordanstown Campus, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, United Kingdom
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Socioeconomic status and inflammation: a meta-analysis. Mol Psychiatry 2020; 25:2189-2199. [PMID: 31628416 PMCID: PMC6814496 DOI: 10.1038/s41380-018-0259-2] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/06/2018] [Accepted: 09/06/2018] [Indexed: 12/17/2022]
Abstract
Socioeconomic status (SES), often conceptualized as income, education, or occupation, is associated with risk for disease morbidity and psychopathology. Recent research has focused on the potential biological mechanisms linking lower SES and poor outcomes; much of this work has examined the relationship between SES and markers of systemic inflammation. The strength of the estimated association between SES and inflammatory markers varies widely across individual studies. Thus, we used meta-analytic techniques to quantify the magnitude of this relationship. To accomplish this, PubMed and PsycINFO were searched for papers that reported on SES and two commonly measured systemic inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6). Peer-reviewed, empirical papers conducted in non-patient populations were included. Data from 43 papers (N = 111,156) reporting a total of 63 relevant effect sizes were included in analyses. SES, broadly defined, was significantly associated with both levels of CRP (Z = 0.12; 95% CI, 0.09-0.16) and IL-6 (Z = 0.15; 95% CI, 0.12-0.18); individuals with lower SES showed higher levels of systemic inflammation. Subanalyses demonstrated that studies operationalizing SES as either levels of income or educational attainment also found significant associations with both CRP and IL-6. Moderator analyses revealed that effect sizes varied based on sample characteristics and analysis approaches. Lower SES is associated with significantly elevated levels of inflammatory markers of disease risk. Thus, pro-inflammatory pathways are likely an important mechanism translating socioeconomic inequalities into mental and physical health disparities.
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Abstract
INTRODUCTION There have been recent mounting concerns regarding multiple reports stating a significantly elevated relative-risk of COVID-19 mortality amongst the Black and Minority Ethnic (BAME) population. An urgent national enquiry investigating the possible reasons for this phenomenon has been issued in the UK. Inflammation is at the forefront of COVID-19 research as disease severity appears to correlate with pro-inflammatory cytokine dysregulation. This narrative review aims to shed light on the novel, pathophysiological role of inflammation in contributing towards the increased COVID-19 mortality risk amongst the BAME population. METHODS Searches in PubMed, Medline, Scopus, medRxiv and Google Scholar were performed to identify articles published in English from inception to 18th June 2020. These databases were searched using keywords including: 'COVID-19' or 'Black and Minority Ethnic' or 'Inflammation'. A narrative review was synthesized using these included articles. RESULTS We suggest a novel pathophysiological mechanism by which acute inflammation from COVID-19 may augment existing chronic inflammation, in order to potentiate a 'cytokine storm' and thus the more severe disease phenotype observed in the BAME population. Obesity, insulin resistance, cardiovascular disease, psychological stress, chronic infections and genetic predispositions are all relevant factors which may be contributing to elevated chronic systemic inflammation amongst the BAME population. CONCLUSION Overall, this review provides early insights and directions for ongoing research regarding the pathophysiological mechanisms that may explain the severe COVID-19 disease phenotype observed amongst the BAME population. We suggest 'personalization' of chronic disease management, which can be used with other interventions, in order to tackle this.
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Affiliation(s)
- Abhinav Vepa
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
| | - Joseph P Bae
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK
| | | | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, UK
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Samuel L, Szanton SL, Fedarko NS, Simonsick EM. Leveraging naturally occurring variation in financial stress to examine associations with inflammatory burden among older adults. J Epidemiol Community Health 2020; 74:892-897. [PMID: 32665370 DOI: 10.1136/jech-2020-213807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/27/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Financial strain is associated with earlier disability and mortality, but causal links are underexplored, partly because it is unethical to randomise people to financial stress. This study leverages naturally occurring random variation in days since monthly Social Security payment arrival among older adults to test associations with inflammatory biomarkers. METHODS Biomarker data, including tumour necrosis factor (TNF)-α, interleukin (IL)-6 and C reactive protein (CRP), was collected from 2155 non-working healthy adults aged 70-79 years, participating in the Health, Aging and Body Composition Study. Days since payment arrival was independent of all demographic, socioeconomic or health characteristics measured in this study. Restricted cubic spline models estimated associations separately for each week of the month, stratified by financial strain status (interaction term p value for TNF-α model <0.05). RESULTS Among financially strained older adults, more days since payment arrival was associated with higher TNF-α levels during the first week of the month (coefficient=0.102). Associations with IL-6 and CRP differed depending on the degree of financial strain (interaction term p values <0.05). Those with low, but not high, strain had lower levels of IL-6 (coefficient=-0.152) and CRP (coefficient=-0.179) during the first week. CONCLUSIONS Days since monthly payments were associated with inflammatory cytokines among older adults who have difficulty making ends meet financially and associations depended on financial strain severity, suggesting that results are attributable to monthly variation in financial stress. Future research should examine whether more frequent Social Security disbursement would modify financial strain and inflammatory biomarkers.
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Affiliation(s)
- Laura Samuel
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Neal S Fedarko
- Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Midlife vulnerability and food insecurity: Findings from low-income adults in the US National Health Interview Survey. PLoS One 2020; 15:e0233029. [PMID: 32658927 PMCID: PMC7357765 DOI: 10.1371/journal.pone.0233029] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/27/2020] [Indexed: 11/19/2022] Open
Abstract
Background Food insecurity, limited access to adequate food, in adulthood is associated with poor health outcomes that suggest a pattern of accelerated aging. However, little is known about factors that impact food insecurity in midlife which in turn could help to identify potential pathways of accelerated aging. Methods Low-income adults (n = 17,866; 2014 National Health Interview Survey), ages 18 to 84, completed a 10-item food security module and answered questions regarding health challenges (chronic conditions and functional limitations) and financial worry. We used multinomial logistic regression for complex samples to assess the association of health challenges and financial worry with food insecurity status and determine whether these associations differed by age group, while adjusting for poverty, sex, race/ethnicity, education, family structure, social security, and food assistance. Results Food insecurity rates were highest in late- (37.5%) and early- (36.0%) midlife, relative to younger (33.7%) and older (20.2%) age groups and, furthermore, age moderated the relationship between food insecurity and both risk factors (interaction p-values < .05, for both). The effects of poor health were stronger in midlife relative to younger and older ages. Unlike younger and older adults, however, adults in midlife showed high levels of food insecurity regardless of financial worry. Conclusions Findings suggest that food insecurity in midlife may be more severe than previously thought. Greater efforts are needed to identify those at greatest risk and intervene early to slow premature aging.
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Petruzzella A, Feinstein BA, Davila J, Lavner JA. Gay-Specific and General Stressors Predict Gay Men's Psychological Functioning Over Time. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1755-1767. [PMID: 32146605 DOI: 10.1007/s10508-020-01672-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
Gay men experience various stressors, including gay-specific stressors such as discrimination and internalized homonegativity as well as general stressors such as occupational and financial strain. While a robust literature has examined how gay-specific stressors are associated with negative mental health outcomes among gay men, less attention has been paid to the association between general stress and gay men's psychological functioning or to how different types of stressors may interact to affect functioning. The current study sought to address this gap by examining the unique and combined associations between gay-specific external stress (discrimination), gay-specific internal stress (rejection sensitivity, internalized homonegativity, sexual identity concealment), and general stressors (e.g., academic difficulties) and negative affect and alcohol use over time. A total of 147 self-identified gay men living in the greater New York City area participated in a baseline assessment and a 7-week diary study. Univariate and multivariate results revealed that gay-specific external stress, gay-specific internal stress, and general stress were each positively and uniquely associated with higher mean levels of and greater fluctuations in negative affect over time, and general stress was positively associated with greater fluctuations in alcohol use over time. Multiplicative analyses indicated that individuals reporting high levels of stress in multiple domains experienced particularly high mean levels of negative affect. These findings highlight the unique contribution of general stress to gay men's functioning over time and underscore the importance of considering multiple forms of stress (i.e., gay-specific and general stress) and their interactions to better understand gay men's psychological functioning.
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Affiliation(s)
- Antonio Petruzzella
- Department of Psychology, University of Georgia, 125 Baldwin Street, Psychology Building, Athens, GA, 30602, USA.
| | - Brian A Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Joanne Davila
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Justin A Lavner
- Department of Psychology, University of Georgia, 125 Baldwin Street, Psychology Building, Athens, GA, 30602, USA
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Slavish DC, Jones DR, Smyth JM, Engeland CG, Song S, McCormick NM, Graham-Engeland JE. Positive and Negative Affect and Salivary Markers of Inflammation Among Young Adults. Int J Behav Med 2020; 27:282-293. [PMID: 31222631 PMCID: PMC8374836 DOI: 10.1007/s12529-019-09795-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Emerging evidence suggests that higher circulating levels of inflammatory biomarkers in blood are associated with higher negative affect (NA) and lower positive affect (PA). To our knowledge, the unique associations between NA and PA in daily life and salivary biomarkers of inflammation have not been examined. This study examined these associations in young adults. METHODS Measures of NA and PA were created from aggregated daily measures of affect (morning and evening ratings averaged across 14 days). We investigated associations between these measures and salivary C-reactive protein (CRP) and interleukin (IL)-6 in a sample of 108 young adults (60% female, mean age = 20.45 ± 1.47), a subset of whom had self-reported chronic back pain (n = 49). CRP and IL-6 were determined from saliva obtained at the end of the daily diary period. RESULTS After covarying for age, gender, body mass index, chronic pain status, salivary flow rate, and NA, higher PA was associated with lower salivary CRP (β = - 0.02, 95% CI (- 0.03, - 0.00) sr2 = .06, p = .01) but not IL-6; removing NA from this model did not change results. In a model with the same covariates (and PA), NA was not significantly related to CRP or IL-6. Chronic back pain status and gender did not moderate results. CONCLUSIONS Findings suggest that higher PA may be associated with lower salivary CRP in young adults, even after accounting for NA and demographic characteristics. Findings highlight the utility of assessing emotional states in relation to salivary markers of inflammation in future biobehavioral research.
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Affiliation(s)
- Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA.
| | - Dusti R Jones
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - Joshua M Smyth
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
- Department of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Christopher G Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Sunmi Song
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul, South Korea
| | - Nolan M McCormick
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
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Gao L, Gan Y, Whittal A, Yan S, Lippke S. The Mediator Roles of Problematic Internet Use and Perceived Stress Between Health Behaviors and Work-Life Balance Among Internet Users in Germany and China: Web-Based Cross-Sectional Study. J Med Internet Res 2020; 22:e16468. [PMID: 32391798 PMCID: PMC7248799 DOI: 10.2196/16468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/09/2019] [Accepted: 02/07/2020] [Indexed: 01/17/2023] Open
Abstract
Background Work-life balance is associated with health behaviors. In the face of digitalization, understanding this link requires a theory-based investigation of problematic internet use and perceived stress, which are so far unknown. Objective On the basis of the compensatory carry-over action model, this study aimed to determine whether problematic internet use and perceived stress mediate the relationship between health behaviors and work-life balance in two groups of internet users from different environments (residents in Germany and China). We also investigated whether the place of residence was a moderator. Methods An online questionnaire (N=877) was administered to residents from Germany (n=374) and China (n=503) in 3 languages (German, English, and Chinese). Moderated mediation analyses were run with health behaviors as the independent variable, work-life balance as the dependent variable, problematic internet use and perceived stress as the mediator variables, and place of residence as a potential moderator. Results On a mean level, individuals in Germany reported less problematic internet use and more health behaviors than individuals in China; however, they also had lower work-life balance and higher perceived stress. Results showed that health behaviors seem to be directly related to work-life balance in both groups. Among the residents of Germany, a partial mediation was revealed (β=.13; P=.01), whereas among the residents of China, a full mediation was found (β=.02; P=.61). The mediator role of perceived stress was compared with problematic internet use in all the serial models and the parallel model. Residence moderated the relationship between health behaviors and work-life balance: The interrelation between health behaviors and work-life balance was stronger in Germany (β=.19; P<.001) than in China (β=.11; P=.01) when controlling for other variables. Conclusions The findings of this study are in line with the compensatory carry-over action model. To promote work-life balance, individuals should perform health behaviors to help overcome problematic internet use and perceived stress. Both problematic internet use and perceived stress mediated health behaviors and work-life balance partially in German study participants and fully in Chinese study participants.
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Affiliation(s)
- Lingling Gao
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Yiqun Gan
- School of Psychological Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Amanda Whittal
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Song Yan
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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